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Division of Newborn Screening and Genetics
Refusal of Newborn Screening Form
Every baby born in Pennsylvania is required to have a dried blood spot (DBS) screening, a critical congenital heart defect
(CCD)
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How to fill out division of newborn screening

How to fill out division of newborn screening
01
Collect a blood sample from the newborn baby using a heel stick or venipuncture method.
02
Place the blood sample on the designated filter paper card provided by the newborn screening program.
03
Ensure that the blood spreads and completely fills the circles on the filter paper card.
04
Allow the blood sample to air dry completely at room temperature.
05
Once the blood sample is dry, place the filter paper card in a protective envelope or container.
06
Complete the necessary information on the envelope or container, including the name and date of birth of the newborn.
07
Submit the filled out division of newborn screening to the appropriate laboratory or healthcare provider as instructed.
Who needs division of newborn screening?
01
Division of newborn screening is recommended for all newborn babies to identify and detect early signs of certain inherited disorders or conditions.
02
It is particularly important for newborns who may have a higher risk of developing these conditions due to family history or other risk factors.
03
Screening can also be beneficial for newborns who appear healthy at birth but may still carry certain genetic disorders that are not apparent without testing.
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What is division of newborn screening?
The division of newborn screening is a form that healthcare providers are required to fill out to report newborn screening results.
Who is required to file division of newborn screening?
Healthcare providers are required to file division of newborn screening.
How to fill out division of newborn screening?
Division of newborn screening can be filled out by healthcare providers using the specific form provided by the relevant authorities.
What is the purpose of division of newborn screening?
The purpose of division of newborn screening is to ensure that newborn screening results are accurately reported and tracked for medical purposes.
What information must be reported on division of newborn screening?
Information such as newborn's name, date of birth, screening results, and healthcare provider's information must be reported on division of newborn screening.
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